what are the treatment options for benign gist tumor treatment

• Surgical Therapy. Those with primary GIST who do not have evidence of metastasis. Those with tumors that are technically resectable if the risks of morbidity are acceptable.
• Chemotherapy
• Tyrosine Kinase Inhibitor Therapy. TKIs have revolutionized the management of GIST. The TKI imatinib mesylate is used as the first-line treatment for unresectable, metastatic, or recurrent GIST.

Full Answer

What is the best treatment for a GIST tumor?

If the GIST is metastatic (has spread), it may be best for you to receive chemotherapy first to shrink it so we can remove it. Your general health should be good enough to have general anesthesia and undergo a surgical procedure.

Is there any need for further treatment after Gist surgery?

The need for further treatment depends on the risk of the GIST coming back after surgery. Tumors that are small and are not growing quickly typically have a low risk of coming back, so often no further treatment is needed.

What are the treatment options for unresectable GISTs?

Treatment options for unresectable GISTs depend on why they are unresectable and, if they have spread, how extensive the spread is. Surgery is not typically the first treatment for these tumors, so before starting treatment, it’s important to confirm that the tumor is in fact a GIST with a biopsy .

What are the treatment options for gastrointestinal stromal tumors?

Radiation therapy is sometimes given as supportive care to relieve pain in patients with large tumors that have spread. New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Treatment for gastrointestinal stromal tumors may cause side effects.

What is the best treatment for GIST?

The targeted drug imatinib (Gleevec) is typically the preferred first treatment for most advanced GISTs. (The targeted drug avapritinib (Ayvakit) might be used instead if the cancer cells have certain changes in the PDGFRA gene.)

Can a GIST tumor be benign?

GISTs can be benign (non-cancerous) at first, but many can turn into cancer and these are then called sarcomas. Surgery is the usual treatment if the tumor has not spread.

Are most GIST tumors benign?

Gastrointestinal stromal tumors (GIST) account for 1% to 3% of all resected gastric tumors. They are mostly benign and are the commonest submucosal mass in the stomach. The preoperative characterization of malignancy is often difficult, and excision is the most common management option.

Can GIST be completely cured?

GIST may be curable if there is one early stage tumor that can be surgically removed without damaging vital organs. This can sometimes be done with minimally invasive laparoscopic surgery. Some people make a full recovery without needing further treatment.

Should benign tumors be removed?

In many cases, benign tumors need no treatment. Doctors may simply use "watchful waiting" to make sure they cause no problems. But treatment may be needed if symptoms are a problem. Surgery is a common type of treatment for benign tumors.

What is benign GIST?

About gastrointestinal stromal tumor (GIST) A benign tumor means the tumor can grow but will not spread. A tumor can start in any part of the GI tract. There are several different types of GI tumors, including gastrointestinal stromal tumor (GIST).

What makes a tumor benign?

It is caused by cells dividing more than normal or not dying when they should. Tumors can be classified as benign or malignant. Benign tumors are those that stay in their primary location without invading other sites of the body. They do not spread to local structures or to distant parts of the body.

When should a GIST be removed?

In the case of GIST, the goal of the procedure is to remove as much of the tumor as possible. A healthcare professional might recommend surgery if your tumor is at least 2 centimeters (cm) in size or if you're experiencing symptoms.

How long can you live with GIST?

5-year relative survival rates for GISTSEER Stage5-Year Relative Survival RateLocalized93%Regional81%Distant53%All SEER stages combined83%Feb 28, 2022

Can GIST tumors disappear?

For some people, the GIST may never go away completely. These people may get regular treatments with targeted therapy drugs or other therapies to help keep the cancer in check and to help relieve symptoms. Learning to live with cancer that doesn't go away can be difficult and very stressful.

Is Chemotherapy Effective for GIST?

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. However, standard chemotherapy is not effective for treating GIST and should not be used.

Does GIST need a chemotherapy?

While surgery is usually the main type of treatment for a GIST, chemotherapy can also be incorporated into a patient's treatment plan. Chemotherapy drugs work by attacking rapidly growing cells within the body; this can help shrink gastrointestinal stromal tumors.

How do they remove a tumor?

GIST Surgery. Surgeons can remove small tumors using a laparoscope, a fiber-optic instrument that they insert through a small cut. For larger tumors, they may need to remove parts of affected organs, like the intestine or liver. GIST rarely spreads into nearby lymph nodes, so doctors usually don’t have to remove those.

Why are GI tumors different from other types of GI tumors?

GISTs are different from more common types of GI tumors because of the type of tissue in which they start. GISTs belong to a group of cancers called soft-tissue sarcomas. Soft-tissue sarcomas develop in the tissues that support and connect the body.

What is the test for tumors?

Doctors use tests that change color if a tumor has too much of a protein called “cKIT” (tyrosine-protein kinase KIT) or a mutation of the protein called platelet- derived growth factor receptor alpha (PDGFRA). They also look for changes in the genes.

Why is it important to take medication for a tumor?

Medication is important for people at risk for the tumor coming back. A recent study showed that 3 years of medicine improves your chance of living longer. Even when you can’t get surgery, certain drugs may improve your chance or curb problems caused by large tumors. Swipe to advance. 1 / 14.

Can you take ripretirib before surgery?

They can be taken before surgery to shrink tumors, after surgery to make it less likely that the cancer will come back, and for tumors that surgeons can’t operate on. If none of these prove successful, your doctor may prescribe ripretirib (Qinlock).”. Swipe to advance. 1 / 14.

Does imatinib slow down tumors?

When imatinib doesn't work, sunitinib ( Sutent) It can also slow down the disease and shrink tumor s. Sunitinib is also a possibility if you have side effects from imatinib and your doctor wants to try another drug. Regorafenib ( Stivarga) is an option if the other two don’t work or you can't take them. If the tumor has metastasized, your doctor may prescribe the kinase inhibitor avapritinib ( Ayvakit ).

Can a tumor cause a tangle?

Before surgery, large tumors may block, tangle, or tear intestines. They may also cause internal bleeding, which can need urgent treatment and blood transfusions. After surgery, there can be infections, bowel obstruction, and heart and lung problems. Keep up with your doctor appointments to make sure you’re OK.

How to remove a tumor from a gist?

If the GIST has not spread and is in a place where surgery can be safely done, the tumor and some of the tissue around it may be removed. Sometimes surgery is done using a laparoscope (a thin, lighted tube) to see inside the body. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope is inserted into one of the incisions. Instruments may be inserted through the same incision or through other incisions to remove organs or tissues.

What is a tumor in the gastrointestinal tract?

Gastrointestinal stromal tumor is a disease in which abnormal cells form in the tissues of the gastrointestinal tract.

How to tell if you have a stromal tumor?

Signs of gastrointestinal stromal tumors include blood in the stool or vomit. These and other signs and symptoms may be caused by a GIST or by other conditions. Check with your doctor if you have any of the following: Blood (either bright red or very dark) in the stool or vomit.

What is the process of finding out if a tumor has spread?

The process used to find out if cancer has spread within the gastrointestinal (GI) tract or to other parts of the body is called staging .

Why do tumors show up brighter on a PET scan?

Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

Is metastatic tumor the same as primary tumor?

The metastatic tumor is the same type of tumor as the primary tumor. For example, if a gastrointestinal stromal tumor (GIST) spreads to the liver, the tumor cells in the liver are actually GIST cells. The disease is metastatic GIST, not liver cancer. YouTube.

Can genetic factors cause stromal tumors?

Genetic factors can increase the risk of having a gastrointestinal stromal tumor. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer.

How to treat a recurrent tumor?

Often the treatment plan will include the treatments described above, such as surgery and targeted therapy . However, they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent tumor. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

What is standard of care for GIST?

This section explains the types of treatments that are the standard of care for GIST. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment.

Why do doctors run tests on tumors?

Because some of these genetic changes in the tumor may mean the drugs described below may not work well, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps doctors better match each patient with the most effective treatment whenever possible.

How to learn about cancer medications?

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications . It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications. Learn more about your prescriptions by using searchable drug databases.

What to do before cancer surgery?

Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of cancer surgery.

How to give systemic therapy?

Common ways to give systemic therapies include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

What is included in a cancer care plan?

Your care plan also includes treatment for symptoms and side effects, an important part of cancer care. Treatment options and recommendations depend on several factors, including the type and stage of tumor, possible side effects, the patient’s preferences, and the patient’s overall health.

What is the treatment for a GIST?

Treatment may involve surgery and/or the use of tyrosine kinase inhibitors (TKI) depending on the extent of disease and tumor sensitivity to TKI. Although recurrence is common for patients with high-risk tumors (refer to Table 1 ), complete resection of localized tumors may be associated with long-term disease-free survival (DFS). [ 2 ] [ Level of evidence: 3iiiDii] Standard chemotherapy is not used because of the insensitivity of GIST to chemotherapeutic agents. [ 3 - 6] Radiation therapy rarely has a role in the management of patients with GIST; it may occasionally be used for pain control in patients with limited, bulky hepatic metastases or with a single, large metastatic lesion fixed to the abdominal or pelvic wall. [ 1 ] [ Level of evidence: 2Div] Whether tumors 2 cm or smaller with a mitotic index of 5 or less per 50 high-power fields require surgery is controversial. Such tumors appear to have low rates of progression and metastasis, [ 7] but the absolute rates are not known with precision. Endoscopic surveillance is an option.

What is a GIST tumor?

Although they comprise fewer than 1% of all gastrointestinal (GI) tumors, GIST are the most common mesenchymal tumors of the GI tract . [ 1] It has been estimated that there are 3,300 to 6,000 new GIST cases per year in the United States. [ 2] A study based on Surveillance, Epidemiology and End Results (SEER) registry data found that the age-adjusted yearly incidence of GIST in the United States was 6.8 per million from 1992 to 2000. [ 3] However, the true incidence is not known, in part because many tumors have not been tested for the characteristic KIT or platelet-derived growth factor receptor alpha ( PDGFRA) gene mutations. In addition, small, indolent GIST, only a few millimeters in diameter, are common in the general population and are not included in cancer registries. [ 4, 5] GIST are equally distributed across all geographic and ethnic groups and men and women are equally affected. Most patients present between the ages of 50 and 80. [ 6] The vast majority of GIST are sporadic, but there are rare familial forms associated with the characteristic heritable mutations in the KIT gene (or, rarely, in succinate dehydrogenase genes in Carney-Stratakis syndrome). Familial GIST may present as multiple primary tumors.

What is the differential diagnosis of GIST?

Because of a relatively broad morphologic spectrum, the differential diagnosis of GIST includes several mesenchymal, neural, and neuroendocrine neoplasms that occur in the abdomen including the following: [ 8] Leiomyoma.

How long do GIST patients survive?

[ 27] In a retrospective study involving 200 patients that predated the use of TKI, the 5-year disease-specific survival rate for GIST patients with primary disease who underwent complete resection of gross disease (N = 80) was 54%, with survival predicted by tumor size; the overall disease-specific survival was 35% at 5 years. [ 11] Other studies, which also predated TKI, reported 5-year survival rates of 40% to 63% for patients undergoing complete resections of GIST.

What is the most common presentation of GI bleeding?

The most common presentation of GIST is GI bleeding, which may be acute (melena or hematemesis) or chronic and results in anemia. [ 10] GIST patients may also present with: An acute abdomen caused by tumor rupture. GI obstruction. Appendicitis-like pain. Other clinical symptoms include the following: [ 2]

How big is a GI tumor?

Typically arising within the muscle wall of the GI tract, GIST range in size from less than 1 cm to more than 40 cm, with an average size of approximately 5 cm when diagnosed clinically. [ 2] Small GIST may form solid subserosal, intramural, or, less frequently, polypoid intraluminal masses. Large tumors tend to form external masses attached to the outer aspect of the gut involving the muscular layers. [ 2] GIST morphology is quite varied; the tumors are composed of the following: [ 8]

Where is the GI tract located?

GIST can occur anywhere along the GI tract, but most often are found in the stomach or small intestine. The American Joint Committee on Cancer (AJCC) Cancer Staging Manual lists the following approximate distributions: [ 7]

Treatment Options for Gastrointestinal Stromal Tumors (GIST)

Once a GIST has been identified, it is important to determine the best way to treat it.

Clinical Trials

Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.

What is the best treatment for a GIST tumor?

For patients who have a more aggressive form of GIST and are at high risk of recurrence, the standard treatment is imatinib ( Gleevec ). This drug targets cells that have the C-KIT mutation, which is present in 87% of GIST tumors. Gleevec has been shown to be effective in preventing GIST from recurring.

How long does it take for a GIST tumor to recur?

The recurrence of GIST is most likely within the first two years after surgery. Therefore, monitoring is recommended at intervals of every 3-6 months, with CT scans.

What happens if a tumor doesn't grow?

If the tumor isn’t growing, or is even getting smaller, that’s a sign that the treatment is effective. When a tumor grows while a patient is on a certain drug, doctors will usually stop that drug since it isn’t controlling the cancer. GIST is different.

What is the drug used for GIST?

The drug regorafenib (Stivarga) is used to treat patients who have tumors that cannot be surgically removed and no longer respond to other GIST treatments. Other agents being evaluated for GIST include sorafenib (Nexavar), dasatinib ( Sprycel) and nilotinib ( Tasigna ).

Can you take Gleevec after surgery?

In certain circumstances, Gleevec may not be recommended after surgery. These circumstances may include KIT negative tumors (13%) or the presence of the PDGFRA gene (4%). In the latter instance, the PDGFRA gene conveys imatinib resistance, but also reduces the risk of GIST recurrence. “There are different kinds of mutations in GIST tumor cells,” ...

Can a GIST be removed surgically?

Metastatic disease cannot be removed surgically, but a localized recurrence may be able to be surgically removed. “Between 10% and 20% of GIST patients have disease that’s spread right from the start,” says Demetri.

Is gastrointestinal stromal tumor treatable?

If you’ve been diagnosed with a gastrointestinal stromal tumor (GIST), there’s good news. GIST has become a treatable disease, thanks to advances in research and treatment over the last 15 years.

How to treat a GIST?

When a GIST continues to grow while you’re on targeted therapy, other treatment options include: 1 removal of the tumor using heat (radiofrequency ablation) 2 radiation therapy to relieve pain and other symptoms 3 surgery to remove as much of a tumor as possible (resection)

What test can be done to determine if a tumor is a GIST?

Your doctor will run a genetic test on your tumor to confirm it’s a GIST and determine its precise genetic mutations. GIST tumors usually have mutations in the KIT or PDGFRA genes.

How is surgery done for a tumor?

For small tumors, surgery is done laparoscopically through small incisions. Larger tumors require open surgery. Sometimes the surgeon has to remove part of the stomach or another organ close to the tumor. Your doctor will let you know what to expect after your surgery.

What does GIST stand for in surgery?

If surgery doesn’t work. Recovery time. Success rates. Takeaway. GIST is an acronym that stands for gastrointestinal stromal tumor. This type of cancer starts in interstitial cells of Cajal (ICCs), which are special cells that line the walls of the gastrointestinal (GI) tract. ICCs send signals to the GI muscles.

What to do if your tumor is positive for PDGFRA?

If your tumor tests positive for a rare genetic mutation known as PDGFRA exon 18, it won’t respond well to standard treatments. Your doctor may prescribe avapritnib (Ayvakit), which is approved specifically for this mutation.

How long do you live after a tumor removal?

When tumors are small enough to remove with surgery, outlook is very good. A small 2018 study reported a 5-year survival rate of 92 percent.

How big is a GIST tumor?

A healthcare professional might recommend surgery if your tumor is at least 2 centimeters (cm) in size or if you’re experiencing symptoms. If your tumor is smaller than 2 cm and not causing symptoms, your doctor may wait and watch to see if it grows ...

Where can a GIST tumor be found?

While most GIST tumors develop in the stomach, they can happen anywhere in your gastrointestinal tract. The size, location and stage of the GIST help determine the best way to remove it. We offer comprehensive surgical options for GIST removal, including:

What is the procedure for a localized GIST?

If you have a primary localized GIST, meaning your cancer has not spread from the area in which it originated, we may suggest one of these surgical options: Partial gastrectomy - removal of part of your stomach. Partial intestine resection - removal of part of your intestine. Abdominoperineal resection - removal of your rectum and anus.

What is partial intestine resection?

Partial intestine resection - removal of part of your intestine. Abdominoperineal resection - removal of your rectum and anus. Whipple procedure (Pancreaticoduodenectomy) - a procedure in which part of your pancreas, a small part of your intestine and sometimes part of your stomach, bile duct, and gallbladder are removed.

How long do you stay in the hospital after a GIST is removed?

Generally, you’ll stay in the hospital for seven to 10 days after surgery to remove a GIST. You can expect to be able to sit in a chair, and in most cases walk, within 24 hours of surgery.

How many tumors are there in the gastrointestinal stromal?

Most people with gastrointestinal stromal tumor have only one tumor. We can cure about 70 percent of patients with surgery alone. The other 30 percent develop a recurrence (when the tumor returns).

What is the procedure called when you have a small part of your stomach removed?

Whipple procedure ( pancreaticoduodenectomy): During this procedure, surgeons remove part of your pancreas, a small part of your intestine, and sometimes part of your stomach, bile duct and gallbladder. Learn more about the Whipple procedure.

Is gastrointestinal stromal tumor surgery or chemotherapy?

If you have an early-stage gastrointestinal stromal tumor (GIST), surgery alone is often an effective treatment. Surgery plus chemotherapy can also provide the best possible outcome even when the tumor has progressed and spread.